Provider Demographics
NPI:1518949080
Name:LOWRY, PHILIP A (MD)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:A
Last Name:LOWRY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11945 JOLLEY WAY
Mailing Address - Street 2:
Mailing Address - City:CORNING
Mailing Address - State:NY
Mailing Address - Zip Code:14830-9154
Mailing Address - Country:US
Mailing Address - Phone:814-380-8323
Mailing Address - Fax:
Practice Address - Street 1:433 W HIGH ST
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:OH
Practice Address - Zip Code:43506-1690
Practice Address - Country:US
Practice Address - Phone:419-630-2291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA76942207RH0003X
OH35.054656207RH0003X
PAMD071964207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA50082614OtherCAPITAL BLUE CROSS
PA0018114970002Medicaid
PA59139OtherGEISINGER HEALTH PLAN
PALO894128OtherHIGHMARK BLUE SHIELD
MIC85234Medicare UPIN
PA50082614OtherCAPITAL BLUE CROSS
MAC85234Medicare UPIN
MALO J13256Medicare ID - Type Unspecified